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D.G. Satria Ambara Putra Gede Eka Wiratnaya , MD, SpOT

AN OUTCOME OF CHRONIC ANTERIOR DISLOCATION OF SHOULDER FOLLOWING OPEN REDUCTION AND SIMULTANEOUS BRISTOW PROCEDURE ( SERIAL CASE ). D.G. Satria Ambara Putra Gede Eka Wiratnaya , MD, SpOT

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D.G. Satria Ambara Putra Gede Eka Wiratnaya , MD, SpOT

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  1. AN OUTCOME OF CHRONIC ANTERIOR DISLOCATION OF SHOULDER FOLLOWING OPEN REDUCTION AND SIMULTANEOUS BRISTOW PROCEDURE • ( SERIAL CASE ) D.G. SatriaAmbara Putra GedeEkaWiratnaya, MD, SpOT Orthopaedic and Traumatology Consultant, Medical Faculty Udayana University, Sanglah General Hospital, Denpasar Bali DewaGdSatriaAmbara Putra AA. Yuda Asmara / Made BramantyaKarna Orthopaedic and Traumatology Department, Medical Faculty Udayana University, Sanglah General Hospital, Denpasar Bali

  2. BACKGROUND • A Glenohumeral joint has remained dislocated for 3 weeks  chronic dislocation • Usually the difficultiiesof reduction and complication are increased along with chronicity of dislocation • There were due to soft tissues contracture, joint reduction may not be stable Araghi A, Prasarn M, Clair SS, Zuckerman JD. Revision anterior shoulder repair for recurrent anterior glenohumeral instability. Bull Hosp Jt Dis. 2005; 62: 102 – 104.

  3. BACKGROUND • Some authors recommended the use of suplemental fixation to maintain postoperative joint reduction • This construct was augmented with a Bristow procedure ( Goga IE. Chronic shoulder dislocation. J Shoulder ElbownSurg 2003;12:446-450.) • Pain and functional disability were common problem arise from chronic shoulder dislocation Is Bristow-Latarjet Operation Effective for Every Recurrent Anterior Shoulder Dislocation? FarzadOmidi-Kashani MD Arch Iranian Med 2008; 11 (3): 270 – 273

  4. METHODS • Between July 2012 and july 2013, two patient unilateral chronic shoulder dislocation were performed open reduction and bristow • MOI was failling in all patients • The patient included two men and all involved right side • We used anterior approach to the shoulder, coracoidosteotomy and reduction of humeral head.

  5. METHODS • Joint fixation by K-wire was used in all patients following operative reduction • Finally, coracoid was fixed at antero inferior of the glenoid. • After three weeks, K-wire was removed and rehabilitation program of the shoulder was begun

  6. DEMOGRAPHIC DATA’S OF PATIENTS OUTCOME

  7. CASE RESULT

  8. CASE 1

  9. CASE 1 Duration 10 months of follow up 80 GOOD

  10. CASE 2

  11. CASE 2 Duration 6 months of follow up 90 GOOD

  12. CASE DISCUSSION

  13. Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair AlirezaRouhani* and AmirmohammadNavali. Rouhani and NavaliSports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2010, 2:15 • Open reduction is prefered treatment for chronic dislocation of the shoulder • Two obstacles; difficulty in reducing humeral head and maintaining reduction • We prefered open reduction because considered by most the literature

  14. Most report have recommended shoulder joint transfixation prevent redislocation • Several techniques of internal fixation can be used after open reduction • Wilson&Mckeeveracromioclavicular cross tranfixing pin • Rockwood & Green Head to glenoid pin • Neviaser recommended transfixing with Swiss screw In our series ,We more familiar did fixation through head to glenoid to prevent redislocation • Rouhani and NavaliSports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2010, 2:15 http://www.smarttjournal.com/content/2/1/15

  15. Several technique show to reinforcement anterior shoulder complex after reduction chronic shoulder dislocation • Alireza R performed simultaneous Bankart lesion repair following open reduction show good result (Treatment of chronic anterior shoulder dislocation by open reduction and simultaneous Bankart lesion repair AlirezaRouhani* and AmirmohammadNavali. Rouhani and NavaliSports Medicine, Arthroscopy, Rehabilitation, Therapy & Technology 2010, 2:15 ) • Open reduction and augmented with a Bristow procedure show good to excelent result( Goga IE. Chronic shoulder dislocation. J Shoulder ElbownSurg 2003;12:446-450.) • In our series, We performed open reduction simultaneous Bristow procedure

  16. We got better exposure by coracoidosteotomy and also facilitated to do reduction • Overall functional outcome were good in all cases • All pt return same level in daily activities • Limited external fixation found in all patient.

  17. CONCLUSION • Many methods of tratment available in chronic shoulder dislocation • Open reduction simultaneous Bristow has good result in treatment chronic anterior dislocation of shoulder

  18. Thank You

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